Can You Have Postpartum Depression After a Miscarriage?

Sarah Ro*, a mom of one from Canada, endured three miscarriages prior to having her rainbow baby. She notes the irony of the entire experience because of her profession as an ultrasound technician. "It's interesting how I've helped so many patients go through similar experiences, but I never thought it could happen to me," she says.

Her first miscarriage happened after an unplanned pregnancy and it was more overwhelming than anything else. Her second miscarriage came six months later, after she and her husband had been trying to get pregnant. This time she felt fear she may never be able to conceive. “I was numb,” says Ro, who had her third miscarriage almost eight months after her second one.

She felt intense sadness and the feeling wasn't easy to shake. Looking back, Ro believes she was suffering from postpartum depression (PPD).

More attention is thankfully being brought on PPD, a mental health condition that affects about 1 in 5 new parents after giving birth. But experts say PPD doesn’t only manifest after giving birth–it can impact people after a miscarriage or a stillbirth. 

About 1 in 4 pregnancies end in miscarriage, while stillbirth impacts 1 in 175 births in the United States. And pregnancy loss can lead to similar hormonal shifts people experience after giving birth. Drops in hormones, including progesterone, are thought to contribute to postpartum depression. On top of that, a miscarriage or stillbirth can lead to intense emotional distress. 

“These symptoms of loss are personal and individual,” says Megan Nelson, LCSW, PMH-C, a therapist on the perinatal mental health team at Helping Hands Psychotherapy in Rockville Centre, New York. “The loss of pregnancy at any stage affects women on a profound level.”

Robyn Alagona Cutler, LMFT, a maternal and perinatal mental health therapist who runs The Postpartum Therapist, says anyone who has been pregnant and then isn’t can go through a postpartum period with mental health issues that include depression and anxiety. The grief felt with a miscarriage is profound, adds Cutler, and anyone going through this pain should know they are not alone.

What Are the Risk Factors for Depression After Pregnancy Loss?

Certain factors can make a person more susceptible to feeling depression after a miscarriage. That includes those who have a history of infertility, a history of depression and anxiety, and being younger in age. Those with a previous experience of pregnancy loss may also be at an increased risk of depression after a miscarriage. 

Symptoms of Depression After Pregnancy Loss

Symptoms of those with postpartum depression or anxiety due to a miscarriage mirror that of people who have the “baby blues” during the first two weeks after delivery, but they last longer. According to Nelson, that includes:

• Sadness
• Hopelessness
• No interest or pleasure in things you once enjoyed
• Loss of appetite
• Trouble sleeping when you want to be sleeping
• Poor concentration
• Irritability
• Excessive crying 
• Loss of energy

Nelson advises people to consult with a health care professional if you are feeling this way for longer than two weeks. But for those experiencing serious symptoms that include thoughts of self-harm and suicide, it’s important to seek out immediate help.

How To Get Help for Depression After Pregnancy Loss

While pregnancy loss and the depression that may follow can be incredibly difficult, there are ways to cope. Here’s what experts recommend. 

Find a community

Whether it’s chatting with loved ones, going to support groups, or seeking out therapy to process the experience, Nelson says “it’s important to trust yourself in asking what you need and seeking it out.” 

For Ro, leaning on family was a saving grace after three miscarriages. "They didn't understand what I was fully going through and they also didn't experience many miscarriages within their social circles, but they were always there to be my support system and listen to me,” she says. 

Facebook groups, such as Miscarriage and Pregnancy Loss Support, also helped her tremendously. "The ability to listen and share in a safe space was very healing and nourishing for me,” she says. “Being vocal allowed me to find inner peace." 

Avoid triggers when you can

It’s also 100% OK to skip out on social settings, particularly if they are triggering, says Nelson. That may include visiting a friend’s new baby, a gender reveal party, or attending a baby shower. “If you prefer to curl up on your couch and binge watch your favorite show, do that,” adds Nelson. 

Limit social media

The same principle applies to social media–avoid accounts that are upsetting and put an overall time cap on how much scrolling you do on your phone.

Limiting her time on social media also helped Ro. "In the beginning, I found myself going down a rabbit hole, which wasn't helpful,” she says. "But in calculated doses, it was therapeutic and what I needed to begin to find closure.”

Give yourself time to heal

Healing won’t happen overnight; it can be a long journey that you should take on your own time. Don’t feel like you have to rush the process. Give yourself time and grace to process everything. 

Remember, people deal with loss differently. “Some people have intense feelings and reactions and others less so,” says Cutler. “Ultimately, there is no ‘right’ way to grieve. People need the space to have their own feelings and reactions with support from others.”

Honor the loss

American culture doesn't often do grief well and Cutler says that the awkwardness, feelings of helplessness, and tension causes us to want to move on from any loss quickly. But this is inherently the problem. 

“We have built a societal norm not to share pregnancy announcements until after the first trimester–as a ‘just in case’ the pregnancy doesn't go to term,” says Cutler. “This needs to change so that those who have a miscarriage will feel supported, regardless of the circumstances.” 

But in other cultures, including Japan, honoring miscarriages through rituals and religious ceremonies is common. This can make healing feel a little easier. 

Bailey Quirion, co-founder and certified pregnancy bereavement nurse at Matriiva, says you can consider adapting these practices in either a religious or non-religious format to help you move through the stages of your grief and find closure. 

“It's really important to note that finding closure does not mean moving on and forgetting your pregnancy, but it can mean coming to a place of acceptance and peace,” Quirion explains.

That can include lighting a candle to honor what has been lost. “It can be a private moment of reflection for you, or a gathering of your partner, friends, or family,” says Quirion. 

Others find comfort by creating a memento box filled with objects that remind them of what would’ve been or through journaling. “Journaling can allow you to explore your own feelings and express them without fear of judgment,” explains Quirion. “Additionally, if you want to share your feelings with someone you trust, your journaling can be a nice prompt to start that conversation. Or, you can let your trusted person read your journal if you feel comfortable doing so.”

Seek treatment

Postpartum mental illnesses are treatable and it can be helpful for those affected by miscarriage to seek out a trustworthy provider who will understand the nuances of what they are going through. A mental health professional that specializes in postpartum can also assess whether or not medication may be helpful or necessary.

“Getting mental health support with a trained perinatal mental health provider early is highly recommended,” confirms Cutler.

There are also several agencies that connect birthing people to both peer support and professional support nationwide. Those include:

• Postpartum Support International (PSI): It has a certified perinatal mental health professional directory as well as a helpline: 1-800-944-4773 (4PPD)
• The National Maternal Mental Health Hotline: Call or text 1-833-TLC-MAMA (1-833-852-6262)
• Suicide and Crisis Lifeline: Call 988

Remember, there is no right or wrong way to grieve and getting help is a good thing. Again, if anyone is having suicidal thoughts, it’s critical to get immediate help.  

*Name has been changed for privacy.